Pregnancy Hot Tub Use

Are warnings about pregnancy hot tub use just old wives' tales? Or, should you stay away from the hot tub when you're expecting?

Should pregnant women avoid hot tubs?

Most of the time, a soak in a hot tub is just a pleasant, relaxing experience. But even when you're not pregnant, hot tubs do come with a few risks:

• Hot tub dermatitis. This skin infection is caused by a bacterium called Pseudomonas aeruginosa, which likes to live in warm water. The rash is red, bumpy, and itchy. Tiny, pus-filled blisters may form, but it usually gets better on its own.
• Overheating. Sitting in a too-hot hot tub, or in any hot bath for too long a time, can raise your body temperature and make you feel weak and dizzy. You may lose your balance or even pass out when you try to stand. In extreme cases, overheating can be fatal.
• Hot tub lung. This lung infection is a rare problem, but it can happen. A tiny organism called Mycobacterium avium can live in the water and be released into the air when whirlpool bubbles burst. If it infects the lungs, it can cause shortness of breath, fever, and cough.

If you've chosen to be extra-careful during your pregnancy, you may want to avoid hot tubs for the reasons listed above. But even if you're comfortable risking a skin rash or an unusual infection, during pregnancy hot tub use may not be a good idea.

Doctors have long worried that the rise in body temperature caused by soaking in a hot tub could be harmful to an unborn baby. Studies in animals showed that elevated body temperature could cause fetal death, but no one knew for sure if the same thing happened in humans. Then, in 2003, researchers at Johns Hopkins decided to see if there was really a connection between pregnancy hot tub use and miscarriage. They tracked over 1,000 women to see if pregnancy loss was more likely in women who used hot tubs. In fact, they found that hot tub users were about twice as likely to have miscarriages. The risk seemed to be highest in the first month of pregnancy and returned to normal around the second trimester.

One caution about this study is that the researchers weren't able to examine every aspect of the women's lives. It's possible that women who tend to use hot tubs have something else in common that puts them at higher risk of miscarriage.

For many years, there has been concern about hot tub use making birth defects more likely. As far back as 1979, the Consumer Product Safety Commission was warning that in the first three months of pregnancy, hot tub use could cause brain damage. In 1992, researchers tracking health issues in over 20,000 women concluded that women who used hot tubs or saunas during pregnancy were more likely to have babies with neural tube defects (neural tube defects are problems with the brain and spinal cord, such as spina bifida). The U.S. Centers for Disease Control and Prevention continue to warn that hot tub use is a risk factor for these types of birth defects.

Your best bet, if you're pregnant, is not to use hot tubs at all. Stay out of saunas and steam rooms, too, since they can also raise your body temperature. If you must have a soak, take precautions to help reduce your risks.

• Don't overheat. Set the water temperature at or below 100 degrees Fahrenheit. Use a thermometer to make sure it's not too hot.
• Keep it short. Keep soaks brief and get out of the hot tub if you feel at all dizzy, weak, or uncomfortable.
• Limit use. There is some evidence that more frequent use raises the risks.

If you need an alternative way to relax aching muscles, consider stretching exercises, yoga, or pregnancy massage. Of course, you should always check with your doctor to make sure what you've chosen is safe.

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